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With medical students restraining the
patient and onlookers eagerly awaiting,
Scottish surgeon Robert Liston
poised himself to begin.
In quick succession,
he cut his patient’s flesh,
sawed through their tibia and fibula
and, within just a few minutes,
the amputation was complete.
It was the 1830s and Liston was renowned
for his surgical speed.
This was important because,
before anesthesia was widely used,
patients had to consciously endure
every moment of surgery.
The quest for anesthetics
that could induce unconsciousness
and enable more meticulous surgeries
launched long before Liston.
Around 200 CE, Chinese physician Hua Tuo
described mixing alcohol
with a powder of various ingredients
to anesthetize patients.
And 13th century Arab surgeon Ibn al-Quff
described patients taking anesthetics,
likely inhaling drugs like cannabis,
opium, and mandrake,
from saturated sponges.
By the end of the 1700s,
many scientists were pondering
chemistry’s medical applications.
This led to a profusion of anesthetic
advancements involving three main players:
nitrous oxide, ether, and chloroform.
In 1799, English chemist Humphry Davy
began experimenting with nitrous oxide,
or laughing gas— inhaling it himself
and observing its effects on friends.
Davy noted that its pain-relieving
abilities might make it useful
for surgical operations—
but it would be decades
before that happened.
This was, at least in part,
because some surgeons and patients
were skeptical of the effectiveness
and safety of anesthetic drugs.
In 1804, Japanese surgeon Seishū Hanaoka
successfully removed a breast tumor
from a patient anesthetized
with a mix of medicinal herbs.
But the news stayed in Japan indefinitely.
Eventually, ether started garnering
medical attention.
It was first formulated centuries before
then came to be used recreationally.
During the so-called “ether frolics”
of the early 1800s,
an American physician noted
that the fall he suffered
while using ether was painless.
In 1842, he etherized a patient
and successfully removed
a tumor from his neck.
In the meantime, dentists finally began
recognizing nitrous oxide’s promise.
But, in 1845, when an American dentist
attempted a public tooth extraction
on someone anesthetized
with nitrous oxide,
he apparently encountered a setback
when his patient screamed.
It was probably just an insufficient dose—
but it was a bad publicity
moment for the drug.
Meanwhile, dentists refined ether
for tooth extractions.
And, in October 1846, an American dentist
administered ether to a patient,
and a surgeon removed
the man’s neck tumor.
Two months later, Liston himself performed
an upper leg amputation
on an etherized patient,
who reportedly regained consciousness
minutes after
and asked when the procedure would begin.
Further ether-enabled successes followed
from India, Russia, and beyond.
But ether had issues,
including unpleasant side effects.
Scottish obstetrician James Simpson
heard about an alternative anesthetic
called chloroform.
And, in 1847, he and two colleagues
decided to try some themselves
and promptly passed out.
Soon after, Simpson
administered chloroform
to one of his patients during childbirth.
It quickly gained popularity
because it was fast-acting
and thought to be side-effect-free—
though we now know it’s harmful
and probably carcinogenic.
Because anesthetics weren’t
yet fully understood,
they sometimes had lethal consequences.
And some doctors held sexist
and racist beliefs that dictated
the amount of anesthesia they’d provide,
if any at all.
American obstetrician Charles Meigs argued
that the pain of childbirth
was a form of divine suffering
and was skeptical that doctors
should interfere with it.
Throughout the 1840s,
American physician James Marion Sims
conducted experimental gynecological
surgeries without pain relief,
primarily upon enslaved Black women.
By the late 19th century,
those who could access anesthetics
were undergoing increasingly
complex operations,
including some that were
previously impossible.
Chloroform came to be understood
as a riskier, more toxic option,
and fell out of favor by the early 1900s.
Alongside newer drugs, ether
and nitrous oxide are still used today—
but in modified formulations that are
safer and produce fewer side effects,
while doctors closely monitor
the patient’s state.
Thanks to these advances,
speed is not always of the essence and,
instead of acute agony,
surgery can feel like just a dream.
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